Device and method for deployment of an anchoring device for intervertebral spinal fusion

ABSTRACT

A device and methods for intervertebral spinal fusion of adjacent intervertebral bodies. An intervertebral spacer is positioned within a narrow disc space between adjacent intervertebral bodies of a patient. The spacer is arranged with upper and lower guides. The guides are adapted to simultaneously guide the deployment of upper and lower anchors of an anchoring device into their respective intervertebral bodies. The spacer is also adapted to lock the upper and lower anchors to the spacer in the deployed position.

CROSS-REFERENCE TO RELATED APPLICATIONS

This patent application is a continuation of U.S. patent applicationSer. No. 14/718,674 filed on May 21, 2015 (published as U.S. Pat. Pub.No. 2016/0338850), which is a continuation of U.S. patent applicationSer. No. 14/718,514 filed on May 21, 2015, now U.S. Pat. No. 10,376,378,which is incorporated in its entirety herein.

FIELD OF THE INVENTION

The present invention relates generally to intervertebral spacers forfusing adjacent vertebras, and more particularly to a device and methodsfor doing so.

BACKGROUND

Intervertebral spinal fusion is well known in the art. In the prior art,an intervertebral spacer is implanted between two adjacentintervertebral bodies. The spacer allows a surgeon to deposit bone graftbetween the problem vertebras in order to fuse the vertebras together.To achieve proper fusion, the implanted spacer must be securely anchoredbetween the vertebras such that there is little to no movement onceimplanted. Protrusions arranged on the superior and inferior surfaces ofthe spacer provides a means to stabilize the spacer between thevertebras. However, it has been discovered that spacers stabilized inthis way may still move due to the stress exerted on the implantedspacer when the patient moves. Other commonly employed stabilizingtechniques include pedicle screws and rods. In this technique, pediclescrews are independently screwed into two or three spine segments. Ashort rod is then used to connect the pedicle screws to prevent motionat the segments that are being fused. However, this technique is timeconsuming because the pedicle screws need to be independently screwedinto the vertebras. It also requires the surgeon to make large/numerousincisions in the patient to insert the pedicle screws. Because of thesedeficiencies in the prior art, there exists a need to provide a moreeffective and efficient way of stabilizing adjacent vertebras in thefield of intervertebral spinal fusion.

SUMMARY

For the purpose of the following description and the appended claims,“proximal” and its inflected forms are defined as the part, portion,section, etc., of an object that is closest to the person using thatobject.

For the purpose of the following description and the appended claims,“distal” and its inflected forms are defined as the part, portion,section, etc., of an object that is furthest away to the person usingthat object.

The present invention provides a way to stabilize adjacent vertebraswithout some of the deficiencies of the prior art discussed above. Inthe illustrative embodiment of the present invention, a spacer isprovide with an upper guide and a lower guide. The upper and lowerguides are adapted to guide the simultaneous deployment of a respectiveupper anchor and lower anchor of an anchoring device when force isapplied thereto. More precisely, force is simultaneously applied to aproximal portion of the upper and lower anchors. The forcesimultaneously deploys the upper and lower anchors into their respectiveintervertebral bodies. The upper and lower anchors are constructed anddimensioned in such a way to pierce and penetrate into their respectivevertebras. The combination of the anchors and the protrusions arrangedon the surfaces of the spacer provides additional stabilization of theimplanted spacer. These advantages of the present invention will beapparent from the following disclosure and the appended claims.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1A depicts a perspective view of an intervertebral spacer inaccordance with an illustrative embodiment of the present invention;

FIG. 1B depicts another perspective view of the intervertebral spacer ofFIG. 1A;

FIG. 2A depicts a top view of the intervertebral spacer of FIGS. 1A and1B;

FIG. 2B depicts a side view of the intervertebral spacer of FIGS. 1A and1B;

FIG. 3A depicts one side of an anchor in accordance with an illustrativeembodiment of the present invention;

FIG. 3B depicts the other side of the anchor of FIG. 3A;

FIG. 4A depicts two anchors being loaded into the intervertebral spacerof FIGS. 1A and 1B;

FIG. 4B depicts the two anchors of FIG. 4A loaded into theintervertebral spacer of FIGS. 1A and 1B, the two anchors being in anundeployed state;

FIG. 5A depicts a perspective view of an implantation instrument inaccordance with an illustrative embodiment of the present invention;

FIG. 5B depicts a cross-sectional view of the implantation instrument ofFIG. 5A, the cross-sectional view depicting a narrower section and awider section of the implantation instrument;

FIG. 5C depicts an exploded, cross-sectional view of the wider sectionof the implantation instrument of FIG. 5A;

FIG. 5D depicts a cross-sectional view of the implantation instrumentgripping the lateral surfaces of the intervertebral spacer of FIGS. 1Aand 1B;

FIG. 6A depicts the implantation instrument of FIG. 5A having deployedthe anchors of FIG. 4A;

FIG. 6B depicts an exploded, top view of the deployed anchors of FIG.6A;

FIGS. 6C and 6D depict an exploded, perspective view of the deployedanchors of FIG. 6A;

FIG. 7A-7C depict a spacer and anchor in accordance with an alternativeembodiment of the present invention, wherein the upper and lower anchorsof the anchoring device form a single, unitary piece;

FIG. 8A-8C depict a spacer and anchor in accordance with an alternativeembodiment of the present invention, wherein the upper and lower anchorsof the anchoring device are disposed entirely within the spacer;

FIG. 9A-9H depict an upper anchor and a lower anchor arranged on a driveplate in accordance with an alternative embodiment of the presentinvention; and

FIG. 10 depicts a spacer having worm gear for deploying one or moreanchors in accordance with an alternative embodiment of the presentinvention.

DETAILED DESCRIPTION

FIGS. 1A and 1B depict perspective views of intervertebral spacer 100 inaccordance with an illustrative embodiment of the present invention.Spacer 100 generally has a rectangular shape, but the present inventionis not limited to such a shape. Spacer 100 can have any shape, size, orcombination thereof to meet the needs of a spinal fusion candidate.

As depicted in FIGS. 1A and 1B, spacer 100 comprises superior surface102, inferior surface 104, lateral surfaces 106 and 108, distal portion110, and proximal portion 112. Inferior surface 104 is a mirror image ofsuperior surface 102 and lateral surface 108 is a mirror image oflateral surface 106. Spacer 100 is preferably formed from titanium alloybut other biocompatible materials (e.g., polyetheretherketone (PEEK),other surgical grade metals, alloys, or a combination thereof) can alsobe used to form spacer 100.

Beginning at distal portion 110, spacer 100 is constructed to have atapered end that narrows towards the distal most end. This design helpsfacilitate easier entry of spacer 100 into the narrow disc spacearranged between two adjacent vertebral bodies.

To fuse the adjacent vertebras together, bone graft is used. For thispurpose, the body of spacer 100 is provided with through-hole 114. Thethrough-hole extends through the center of surfaces 102, 104, 106, and108 and is adapted to receive the bone graft for fusing the adjacentvertebras. In the illustrative embodiment, through-hole 114 generallyhas a rectangular shape. However, those skilled in the art willappreciate after reading this disclosure that through-hole 114 can haveany shape, size, or a combination thereof. As further depicted in FIGS.1A and 1B, surfaces 102 and 104 are provided with a plurality ofprotrusions or teeth 116 to help prevent spacer 100 from expulsion afterbeing implanted between the adjacent vertebras. It will be appreciatedby those skilled in the art, after reading this disclosure, that teeth116 can be angled in any number of degrees (e.g., 45°, 90°, etc.) andcan have any number of orientations without departing from the scope ofthe present invention. Through-hole 114 and teeth 116 can be seen moreclearly in FIGS. 2A and 2B.

Turning now to proximal portion 112, upper and lower guides are providedto respectively guide the deployment of upper anchor 118 and loweranchor 120 into their respective vertebral bodies. The upper and loweranchors will be discussed in more detail below, with respect to FIGS. 3Aand 3B. In the illustrative embodiment, the upper guide is characterizedby an upper inclined surface 122 (e.g., a curvilinear surface, etc.) andan upper pair of oppositely positioned lateral recesses 124. Because thelower guide is a mirror image of the upper guide, the lower guide isalso characterized by a lower inclined surface 126 and a lower pair ofoppositely positioned lateral recesses 128. The upper and lower pair oflateral recesses 124 and 128 are dimensioned to respectively complementthe arc, curvature, etc., of the upper and lower anchors. An advantageof recesses 124 and 128 is that they ensure that their respectiveanchors maintain a desired trajectory when impacted by an anchor driver.The recesses 124 and 128 also prevent their respective anchors fromegressing out of spacer 100 when impacted by the anchor driver. Thesefeatures and their advantages will be discussed in more detail below,with reference to FIGS. 4A and 4B.

Proximal portion 112 also comprises a pair of oppositely positionedlateral chamfers 130 and 132. Each of the lateral chamfers has a slopingedge and is positioned proximally to their respective locking recesses134, 136, 138, and 140. As will be described in more detail below, withreference to FIGS. 6A-6D, the chamfer-recess combination is a mechanismthat allows upper anchor 118 and lower anchor 120 to be locked to spacer100 after deployment. It will be appreciated by those skilled in theart, after reading this disclosure, that locking recesses 134, 136, 138,140 could be detents in some embodiments and through-holes in otherembodiments.

Proximal portion 112 further comprises lateral surfaces 142 and 144 thatare respectively constructed with gripper recesses 146 and 148. Thegripper recesses are dimensioned and arranged to receive correspondingribs of an implantation instrument employed by a surgeon. The ribs areadapted to fit squarely into their corresponding recesses so that spacer100 can be securely gripped by the surgeon. It should be noted thatgripping the spacer with an implantation instrument serves at least twopurposes. First, it enables the surgeon to more easily orient spacer 100in a desired position within the narrow disc space of the adjacentvertebras. Secondly, it prevents spacer 100 from coming free from theimplantation instrument while the surgeon is impacting the upper andlower anchors with an anchor driver. Although each of the lateralsurfaces is depicted as having three gripping recesses, it will beappreciated by those skilled in the art that each of the lateralsurfaces can have more or less gripper recesses than depicted. Thisfeature of the present invention will be described in more detail below,with reference to FIGS. 5A-5D.

FIGS. 3A and 3B are perspective views of an anchor in accordance with anillustrative embodiment of the present invention. Since upper anchor 118and lower anchor 120 have substantially the same physical and functionalcharacteristics, thus being interchangeable, the following discussion ofFIGS. 3A and 3B will use the word “anchor” to describe both the upperand lower anchors. Further, it should be noted that upper anchor 118 andlower anchor 120 (whether formed as independent pieces or as a singleunitary piece) collectively define an anchoring device.

FIG. 3A depicts the surface of an anchor that is adapted to slide alongan inclined surface of a guide (e.g., upper inclined surface 122 orlower inclined surface 126). In the illustrative embodiment, the anchoris constructed to have a curved or semi-curved surface that is contouredto be substantially the same as the inclined surface of the guide itslides on. The surface of the anchor is preferably smooth throughout itslength in order to reduce the amount of friction drag produced when thesurface slides along the inclined surface.

The anchor also comprises a pair of oppositely positioned lateral sides302 and 304, which are adapted to slide into their respective lateralrecesses (e.g., upper lateral recesses 124 or lower lateral recesses128). The anchor is also constructed with a pair of flexible prongs 306and 308, which respectively comprises lateral projections 310 and 312.The flexible prongs and lateral projections work in cooperation to lockthe anchor to spacer 100 in a deployed position. The lateral sides,flexible prongs, and lateral projections of the anchor are also depictedin FIG. 3B.

To enable the anchor to penetrate a vertebral body, distal portion 314of the anchor is tapered to form an edge. Since the anchor is made oftitanium alloy, the distal portion of the anchor is sufficiently strongto pierce and penetrate through the endplate of the vertebral body.Although the anchor is preferably formed from titanium alloy, otherbiocompatible materials (e.g., polyetheretherketone (PEEK), othersurgical grade metals, alloys, or a combination thereof) can be used toform the anchor.

It will be clear to those skilled in the art that the foregoingdiscussion of FIGS. 3A and 3B applies to both upper anchor 118 and loweranchor 120.

FIG. 4A depicts upper anchor 118 and lower anchor 120 being loaded intospacer 100. As discussed above, the upper guide of spacer 100 has anupper pair of oppositely positioned lateral recesses 124. Each lateralrecess 124 is adapted to receive a respective one of lateral sides 302and 304 of upper anchor 118. Similarly, the lower guide of spacer 100has a lower pair of oppositely positioned lateral recesses 128 (shownmore clearly in FIG. 1B). Each lateral recess 128 is adapted to receivea respective one of lateral sides 302 and 304 of lower anchor 120.Turning now to FIG. 4B, this figure depicts spacer 100 loaded with theupper and lower anchors. In FIG. 4B, upper anchor 118 and lower anchor120 are in an undeployed state and are disposed entirely within spacer100. That is, no part of upper anchor 118 and lower anchor 120 extendbeyond the profile of teeth 116 arranged on spacer 100. In theloaded/undeployed state, spacer 100 is ready to be gripped by animplantation instrument for simultaneous deployment into theirrespective intervertebral bodies.

FIG. 5A is a perspective view of implantation instrument 500, whichcomprises, inter alia, housing 502, anchor driver 504, handle 506, and apair of oppositely positioned grippers 508 and 510. As will be discussedin more detail below, with reference to FIGS. 5B-5D, anchor driver 504can be advanced forwards or retracted backwards via handle 506 torespectively grip or release spacer 100.

FIG. 5B is a cross-sectional view of the implantation instrument of FIG.5A. As shown in this view, housing 502 is divided into twosections—namely, a narrower section 512 and a wider section 514. Anchordriver 504 is constructed to fit squarely into narrower section 512 withlittle or no lateral and radial movement, while the area of widersection 514 is dimensioned to accommodate the width of anchor driver 504and a pair of adjacently positioned, oppositely bowed leaf springs 516and 518.

In the configuration depicted in FIG. 5B, anchor driver 504 can beadvanced forwards towards leaf springs 516 and 518 via handle 506. Asthe forward advancement causes anchor driver 504 to be wedged betweenleaf springs 516 and 518, their respective grippers 508 and 510 willbegin to simultaneously pivot inward to clamp onto the lateral surfacesof spacer 100.

More precisely, and with reference to FIG. 5C, the forward advancementof anchor driver 504 causes gripper 508 to pivot inwardly about pivotpoint 520. This pivot action is a result of leaf spring 516 beingcompressed outwards towards the wall of housing 502 as anchor driver 504engages the bowed portion of leaf spring 516. As gripper 508 pivotsinwards, ribs 524 engage their respective gripper recess 146 (depictedin FIG. 1A) arranged on spacer 100. Likewise, gripper 510 will pivotinwardly about pivot point 522 in response to the forward advancement ofthe driver, resulting in ribs 526 engaging their respective gripperrecess 148 (depicted in FIG. 1B). By means of the foregoing, spacer 100can be securely gripped by implantation instrument 500, as depicted inFIG. 5D.

As depicted in FIG. 5D, the head of anchor driver 504 stops at orslightly before the distal end of housing 502 after gripping spacer 100.While spacer 100 is being gripped by implantation instrument 500, spacer100 is positioned within the narrow disc space between adjacentvertebras. Continuing to grip spacer 100 with implantation instrument500, the surgeon removes cap 530 and is now ready to impact handle 506with a weighted object (e.g., hammer, mallet, etc.). In accordance withthe illustrative embodiment, cap 530 has two functionalities. First, cap530 when attached to handle 506 disallows forward movement of anchordriver 504 past a certain point—namely, the distal end of housing 502.Secondly, cap 530 prevents inadvertent deployment of upper anchor 118and lower anchor 120 during positioning of spacer 100 within theadjacent vertebral bodies.

When the surgeon impacts handle 506 with a weighted object, anchordriver 504 is driven forwards into the proximal portion of upper anchor118 and lower anchor 120, thereby simultaneously deploying the anchorsinto their respective vertebras. The surgeon may impact handle 506 oneor more times so that the anchors reach a desired depth within theirvertebras, and so that the anchors engage the locking feature of thepresent invention described in more detail below. Once upper anchor 118and lower anchor 120 is locked to spacer 100 in the deployed position,the surgeon can retract anchor driver 502 so that leaf springs 516 and518 can return to their relaxed state. While returning to their relaxedstate, grippers 508 and 510 will begin to pivot outwardly to disengagefrom their gripper recesses, thereby releasing spacer 100.

FIG. 6A depicts a perspective view of implantation instrument 500 inwhich driver anchor 504 has simultaneously deployed upper anchor 118 andlower anchor 120. As discussed above, the head of anchor driver 504 issimultaneously driven into the proximal portion of upper anchor 118 andlower anchor 120 as the surgeon impacts handle 506. This causes both theupper anchor 118 and lower anchor 120 to independently slide along theupper inclined surface 122 and lower inclined surface 126, respectively.The upper and lower inclined surfaces respectively press against thesurface of the upper and lower anchors (i.e., the surface depicted inFIG. 3A) to deploy the anchors into their respective vertebral bodies.FIGS. 6B-6D depict upper anchor 118 and lower anchor 120 simultaneouslydeployed after being impacted by anchor driver 504. As shown in thesefigures, the distal ends of upper anchor 118 and lower anchor 120 in thedeployed state are radially extended outside of spacer 100. That is, thedistal ends of upper anchor 118 and lower anchor 120 extend past theheight of teeth 116 of spacer 100 after being deployed.

From the foregoing discussion, it will be clear to those skilled in theart that upper anchor 118 and lower anchor 120 are separate elementsthat slide independently of each other along their respective upper andlower guides. It will also be clear from the foregoing discussion thatan advantage of using the upper and lower anchors of the presentinvention is that they provide additional anchorage for stabilizing aspacer. In other words, not only is the spacer anchored to theintervertebral bodies via its teeth, the spacer is also provided withadditional anchorage by the upper and lower anchors, since they extendpast the profile of the teeth and therefore penetrating deeper into theintervertebral bodies.

Returning to FIGS. 6C and 6D, these figures depict upper anchor 118 andlower anchor 120 locked to spacer 100 in a deployed position. Sinceupper anchor 118 and lower anchor 120 are locked to spacer 100 insubstantially the same way, the following discussion of FIGS. 6C and 6Dwill use the word “anchor” to describe both the upper and lower anchors.

As the anchor is impacted by driver 504, lateral projections 310 and 312will respectively engage the sloping edge of lateral chamfers 130 and132. Lateral chamfers 130 and 132 are depicted in the figures as beingarranged proximally to locking recesses 134, 136, 138, and 140 of spacer100. The pressure and force of the impact causes flexible prongs 306 and308 to flex laterally inwardly. As lateral projections 310 and 312 pasttheir respective lateral chamfers, flexible prongs 306 and 308 willreturn to a relaxed state, thereby causing lateral projections 310 and312 to laterally extend into their corresponding locking recess 134,136, 138, and 140. This locking feature of the present inventionprevents the anchors from disengaging from spacer 100 after beingdeployed into the vertebral bodies.

It will be clear to those skilled in the art, after reading thisdisclosure that numerous modification can be made to the illustrativeembodiment without departing from the scope of the invention. Forexample, in one alternative embodiment, upper anchor 118 and loweranchor 120 can be constructed as a single unitary piece. FIGS. 7A-7Cdepict such an anchoring device.

As depicted in FIG. 7A, upper anchor 702 of anchoring device 700comprises underside 704 that is adapted to press against upper inclinedsurface 706 of the upper guide arranged on spacer 100. Similarly, loweranchor 708 of anchoring device 700 comprises underside 710 that isadapted to press against lower inclined surface 712 of the lower guidearranged on spacer 100. As anchoring device 700 is advanced forwards,pressure causes the undersides to press against their respectiveinclined surfaces, which guides upper anchor 702 and lower anchor 708 toradially and simultaneously deploy into their respective vertebralbodies. As depicted in FIGS. 7B and 7C, upper anchor 702 and loweranchor 708 extend past the profile of teeth 714 to provide additionalanchorage. Once the upper and lower anchors have been simultaneouslydeployed into their vertebra, locking cap 716 can be used to lock theanchors in their deployed position. Specifically, locking cap 716 isadapted to press the proximal end of anchoring device 700 to lock theanchoring device to spacer 100.

In another embodiment, as depicted in FIGS. 8A-8C, spacer 100 housesboth upper anchor 802 and lower anchor 804. In other words, both theupper and lower anchors are disposed entirely within spacer 100 when theanchors are in a relaxed state. As shown in FIG. 8B, an internal drivescrew 806 (i.e., an anchor drive) can be turned so that wedge 812 can beadvanced forwards towards the bowed portion of both upper anchor 802 andlower anchor 804. Wedge 812 is forcibly advanced towards the bowedportion to simultaneously force upper anchor 802 and lower anchor 804 toextend through an opening arranged on superior surface 808 and inferiorsurface 810 of spacer 100. More precisely, as drive screw 806 is turned,wedge 812 abuts against the bowed portion of upper anchor 802 and loweranchor 804. As wedge 812 abuts against the bowed portion of the anchors,the inclined surface of wedge 810 slides along the surface of upperanchor 802 and lower anchor 804. The sliding motion applies pressure tothe surfaces of the anchors, thereby forcing both upper anchor 802 andlower anchor 804 to radially extend outside of the openings of spacer100 and into their respective intervertebral bodies.

In a further embodiment, as depicted in FIGS. 9A-9H, the anchoringdevice has a drive plate 906 from which upper anchor 902 and loweranchor 904 extend.

The drive plate of FIG. 9A includes through-hole 908 arranged at itscentral axis. The drive plate can be divided into four quadrants, withthrough-hole 908 being the origin point, like in a two-dimensionalCartesian plane. Upper anchor 902 extends from a first one of thequadrants (e.g., Quadrant I in a two-dimensional Cartesian plane), whilelower anchor 904 extends from a second one of the quadrants (e.g.,Quadrant III in the two-dimensional Cartesian plane), wherein the firstand second quadrants are diagonally located from each other on driveplate 906. Although the anchors have been described as having a specificarrangement on drive plate 906, it will be clear to those skilled in theart after reading this disclosure that upper anchor 902 and lower anchor904 can be arranged anywhere on the drive plate without departing fromthe scope of the present invention.

As further depicted in FIG. 9A, each of upper anchor 902 and loweranchor 906 has a pointed tip and a plurality of projections arranged ontheir lateral surfaces. The plurality of projections can be, forexample, and without limitation, barbs that are angled away from thepoint in which the anchors penetrate into their respective vertebras.The barbs are advantageous because they make it difficult for theanchors to come loose, thus ensuring that the spacer is securelystabilized between the vertebras after implantation. FIG. 9A alsodepicts a pair of oppositely positioned grippers of holder 910 grippingonto the lateral surfaces of drive plate 906.

Turning now to FIG. 9B, while drive plate 906 is gripped by holder 910,a surgeon can position the grippers of holder 910 to also grip ontoendplate 912 of spacer 900. Once endplate 912 is gripped by the surgeon,a driver 914 can be inserted into holder 910, which passes throughthrough-hole 908 of drive plate 906. The driver engages one end of drivescrew 916 (shown in FIG. 9C) housed within spacer 900. Once the driverhas engaged the drive screw, the surgeon can turn driver 914 so thatdrive screw 916 can be threaded into the body of wedge 918. This causeswedge 918 to move backwards towards the proximal end of spacer 900,which in turn causes superior surface 920 and inferior surface 922 ofthe spacer to slide along the inclined surface of wedge 918. This can beseen more clearly in FIGS. 9C and 9D. As superior surface 920 andinferior surface 922 radially extend in opposite directions of eachother, upper anchor 902 and lower anchor 904 engage upper guide 924 andlower guide 926 of spacer 900. As shown in FIG. 9D, the tips of upperanchor 902 and lower anchor 904 do not extend past the profile of teeth928 of spacer 900, even after superior surface 920 and inferior surface922 have been fully extended.

Once the superior and inferior surfaces of spacer 900 have been fullyextended, the surgeon can now retract driver 914 and insert pull screw930 (i.e., anchor driver) as shown in FIG. 9E. Pull screw 930 isphysically adapted to be inserted through through-hole 908 and into thethreaded hole of drive screw 916. Pull screw 930 can now be threaded toadvance drive plate 906 towards the proximal end of spacer 900, whichcauses upper anchor 902 and lower anchor 904 to respectively slide alongupper guide 924 and lower guide 926 as the drive plate is advancedtowards the proximal end of the spacer. As upper anchor 902 and loweranchor 904 slide along their respective guides, the anchorssimultaneously and radially extend away from spacer 900 and into theirrespective intervertebral bodies. Pull screw 930 is threaded by thesurgeon until drive plate 906 is fully seated against endplate 912. Notonly does threading pull screw 930 in this way fully deploy the anchorsinto their respective intervertebral bodies, it also locks the anchorsto spacer 900 in a deployed position, as shown in FIGS. 9F-9H.

FIG. 10 depicts a spacer-anchor combination in accordance with analternative embodiment of the present invention. More specifically, thefigure depicts spacer 1000, a plurality of upper anchors 1002, worm1004, and gear 1006. In accordance with this embodiment, the worm isphysically adapted to turn the gear, but the gear cannot turn the worm.This is because the angle on the worm is so shallow that, when the geartries to spin it, the friction between the gear and the worm holds theworm in place. With this in mind, a surgeon can implant spacer 1000 inthe disc space of adjacent vertebras. The surgeon can then use a tool toturn worm 1004 in order to rotate gear 1006 in a particular direction.As the gear rotates, upper anchors 1002 are simultaneously deployed intoan intervertebral body. Once deployed, pressure from adjacent vertebrascompressing down onto gear 1006 will not cause the gear to rotate. Thisis because, as discussed above, the angle on the worm is so shallow thatthe friction between the gear and the worm essentially locks the worm inplace. Accordingly, upper anchors 1002 will be locked in their deployedposition until worm 1004 is operated.

It is to be understood that the disclosure describes a few embodimentsand that many variations of the invention can easily be devised by thoseskilled in the art after reading this disclosure and that the scope ofthe present invention is to be determined by the following claims.

What is claimed is:
 1. An intervertebral fusion system comprising: aspacer adapted to be implanted between an upper vertebral body and alower vertebral body, the spacer comprising a proximal end and anopposite distal end, a superior surface and an opposite inferiorsurface, a first lateral surface and an opposite second lateral surface,a lateral through-hole extending between the first and second lateralsurfaces, a central through-hole formed through the superior surface, anupper guide and a lower guide, wherein the upper guide comprises anupper inclined surface which extends from the proximal end of the spacerdistally towards the superior surface and the lower guide comprises alower inclined surface which extends from the proximal end of the spacerdistally towards the inferior surface, wherein the proximal end of thespacer comprises a first opening formed through the superior surface, asecond opening formed through the inferior surface, and a third openingformed through a proximal-most surface of the proximal end, wherein thefirst, second and third openings are continuous with each other suchthat the proximal end of the spacer is open from the proximal-mostsurface to a distal end of the upper guide and from the proximal-mostsurface to a distal end of the lower guide; an anchoring device, formedas a unitary one-piece construction, having an upper anchor and a loweranchor, wherein the upper and lower anchors are configured to bedeployed into the upper and lower vertebral bodies, respectively, alongthe upper and lower guides; and a locking cap configured to be insertedinto the spacer to contact the anchoring device and lock the upperanchor and the lower anchor to the spacer, wherein the locking cap isconfigured to be inserted into the spacer after the upper anchor andlower anchor are deployed.
 2. The intervertebral fusion system of claim1, wherein the upper and lower guides are part of a wedge, and the upperand lower anchors are configured to slide along the upper and lowerguides of the wedge, respectively, when force is applied to theanchoring device.
 3. The intervertebral fusion system of claim 1,wherein the upper anchor includes an underside configured to pressagainst the upper inclined surface and the lower anchor includes anunderside configured to press against the lower inclined surface.
 4. Theintervertebral fusion system of claim 1, wherein the superior surfaceand the inferior surface each include a plurality of teeth.
 5. Theintervertebral fusion system of claim 4, wherein the upper anchor andthe lower anchor extend past a profile of the plurality of teeth of eachof the top surface and the bottom surface when deployed.
 6. Theintervertebral fusion system of claim 1, wherein the locking cap isconfigured to press a proximal end of the anchoring device to lock theupper anchor and the lower anchor to the spacer when deployed.
 7. Amethod for implanting an intervertebral fusion system comprising:gripping a spacer using an implantation instrument, wherein the spacerhas a proximal end and an opposite distal end, a superior surface and anopposite inferior surface, a first lateral surface and an oppositesecond lateral surface, a lateral through-hole extending between thefirst and second lateral surfaces, a central through-hole formed throughthe superior surface, an upper guide and a lower guide for respectivelyguiding deployment of an upper anchor and a lower anchor of an anchordevice, the anchor device formed as a unitary one-piece construction;wherein the upper guide comprises an upper inclined surface whichextends from the proximal end of the spacer distally towards thesuperior surface and the lower guide comprises a lower inclined surfacewhich extends from the proximal end of the spacer distally towards theinferior surface, wherein the proximal end of the spacer comprises afirst opening formed through the superior surface, a second openingformed through the inferior surface, and a third opening formed througha proximal-most surface of the proximal end, wherein the first, secondand third openings are continuous with each other such that the proximalend of the spacer is open from the proximal-most surface to a distal endof the upper guide and from the proximal-most surface to a distal end ofthe lower guide; positioning the spacer between an upper vertebral bodyand a lower vertebral body; advancing the upper anchor and the loweranchor of the anchor device into the proximal end of the spacer causingthe upper anchor and lower anchor to radially and simultaneously deployinto the respective vertebral bodies; and inserting a locking cap intothe spacer after the anchor device has been deployed to contact aproximal end of the anchor device and lock the upper anchor and loweranchor to the spacer.
 8. The intervertebral fusion system of claim 7,wherein the upper and lower guides are part of a wedge, and the upperand lower anchors are configured to slide along the upper and lowerguides of the wedge, respectively, when force is applied to the anchordevice.
 9. The method of claim 7, wherein the upper anchor includes anunderside configured to press against the upper inclined surface and thelower anchor includes an underside configured to press against the lowerinclined surface.
 10. The method of claim 7, wherein the superiorsurface and the inferior surface each include a plurality of teeth. 11.The method of claim 10, wherein the upper anchor and the lower anchorextend past a profile of the plurality of teeth of each of the topsurface and the bottom surface when deployed.
 12. The method of claim 7,wherein the locking cap is configured to press the proximal end of theanchor device to lock the upper anchor and the lower anchor to thespacer when deployed.